Clinical Development of Cancer Treatment

A special issue of Pharmaceuticals (ISSN 1424-8247).

Deadline for manuscript submissions: closed (28 January 2022) | Viewed by 20414

Special Issue Editor


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Guest Editor
Department of Experimental Therapeutics, National Cancer Center Hospital Tokyo, Tokyo, Japan
Interests: cancer chemotherapy; clnical trail; phase I clinical trial; quality of care

Special Issue Information

Dear Colleagues,

Immunotherapy and precision therapy for cancer patients are pivotal in clinical practice and drug development, and the past few years have brought numerous novel agents to clinical development. However, it is just as important to achieve a better understanding od the mechanism of resistance to both targeted and immunotherapy so we can improve the efficacy and development of new strategies to overcome drug resistance.

This Special Issue is a response to an anticipated expansion in preclinical and clinical trials in oncology. Topics of interest include advances in epidemiology, risk factors, diagnosis including molecular expression, genetic profiling, investigation of new drugs, and clinical development in the field of medical oncology. In particular, this Special Issue will highlight new cancer clinical trials, including immunotherapy and precision therapy, and discuss new predictive biomarkers, therapeutic targets, and novel therapeutic approaches.

Dr. Shunsuke Kondo
Guest Editor

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Keywords

  • Cancer chemotherapy
  • Clinical trial
  • Therapeutic agents
  • Immunotherapy
  • Targeted therapy

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Published Papers (5 papers)

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Research

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20 pages, 2105 KiB  
Article
Protective and Therapeutic Efficacy of Hesperidin versus Cisplatin against Ehrlich Ascites Carcinoma-Induced Renal Damage in Mice
by Nahed Saleh, Tamer Allam, Reda M. S. Korany, Abdelfattah M. Abdelfattah, Ahmed M. Omran, Mabrouk Attia Abd Eldaim, Aziza M. Hassan and Nermeen Borai El-Borai
Pharmaceuticals 2022, 15(3), 294; https://doi.org/10.3390/ph15030294 - 28 Feb 2022
Cited by 19 | Viewed by 3535
Abstract
This study evaluates the antitumor efficacy of hesperidin (Hesp) versus cisplatin (Cis) in Ehrlich ascites carcinoma (EAC)-bearing mice, as well as its protective effect against Cis-triggered nephrotoxicity. Seventy female mice were allocated into control, Hesp, EAC, Hesp-protected, Hesp-treated, Cis-treated, and Cis+Hesp-treated groups. The [...] Read more.
This study evaluates the antitumor efficacy of hesperidin (Hesp) versus cisplatin (Cis) in Ehrlich ascites carcinoma (EAC)-bearing mice, as well as its protective effect against Cis-triggered nephrotoxicity. Seventy female mice were allocated into control, Hesp, EAC, Hesp-protected, Hesp-treated, Cis-treated, and Cis+Hesp-treated groups. The inoculation of mice with EAC cells significantly reduced the mean survival time, while significantly increased the body weight, abdominal circumference, ascitic fluid volume, viable tumor cell count, and serum carcinoembryonic antigen, urea and creatinine levels, besides various hematological changes. Additionally, kidney tissue of EAC-bearing mice showed a significant increase in the malondialdehyde level, significant decreases in the reduced glutathione content and catalase activity, marked pathological alterations, and a strong Ki-67 expression with a weak caspase-3 expression in neoplastic cells infiltrating the renal capsule. Conversely, the administration of Hesp and/or Cis to the EAC-bearing mice induced, to various degrees, antitumor responses and alleviated the cytotoxic effects of EAC. In addition to the potent antitumor effect of the concomitant administration of Hesp and Cis, Hesp minimized the renal adverse side effects of Cis. In conclusion, Hesp may open new avenues for safe and effective cancer therapy and could be valuable for enhancing the antitumor potency and minimizing the renal adverse side effects of chemotherapeutic drugs. Full article
(This article belongs to the Special Issue Clinical Development of Cancer Treatment)
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11 pages, 781 KiB  
Article
Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
by Jae Hee Choi, Min Jung Geum, Ji Eun Kang, Nam Gi Park, Yun Kyoung Oh and Sandy Jeong Rhie
Pharmaceuticals 2021, 14(11), 1200; https://doi.org/10.3390/ph14111200 - 22 Nov 2021
Cited by 2 | Viewed by 2365
Abstract
Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. [...] Read more.
Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. Here, we retrospectively reviewed the electronic medical records of 320 patients who completed adjuvant AC-based chemotherapy from September 2016 to September 2020. Approximately 46.6% of the patients developed severe neutropenic events (SNE) during AC-based chemotherapy. Secondary prophylaxis of G-CSF reduced the risk of recurrent SNE (p < 0.01) and the relative dose intensity (RDI) < 85% (p = 0.03) in patients who had experienced SNE during AC-based chemotherapy. Age ≥ 65 years (p = 0.02) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 60 IU/L (p = 0.04) were significant risk factors for RDI < 85%. The incidences of FN, grade 4 neutropenia, unscheduled hospitalization, and interruption to the dosing regimen were reduced in patients administered secondary prophylaxis with G-CSF (before vs. after administration: FN, 19.4% vs. 4.6%; grade 4 neutropenia, 86.1% vs. 14.8%; unscheduled hospitalization, 75.9% vs. 11.1%; interruption to the dosing regimen, 18.5% vs. 8.3%). This study indicated the importance of active intervention of G-CSF use to prevent recurrent SNE and improve clinical outcomes in patients with breast cancer who receive AC-based chemotherapy. Full article
(This article belongs to the Special Issue Clinical Development of Cancer Treatment)
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Review

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20 pages, 1004 KiB  
Review
Effect and Mechanism of Herbal Medicines on Cisplatin-Induced Anorexia
by Daeun Min, Bonglee Kim, Seong-Gyu Ko and Woojin Kim
Pharmaceuticals 2022, 15(2), 208; https://doi.org/10.3390/ph15020208 - 9 Feb 2022
Cited by 5 | Viewed by 4968
Abstract
Cisplatin is a well-known chemotherapeutic agent used to treat various types of cancers; however, it can also induce anorexia, which results in reduced food intake, loss of body weight, and lower quality of life. Although drugs such as megestrol acetate and cyproheptadine are [...] Read more.
Cisplatin is a well-known chemotherapeutic agent used to treat various types of cancers; however, it can also induce anorexia, which results in reduced food intake, loss of body weight, and lower quality of life. Although drugs such as megestrol acetate and cyproheptadine are used to decrease this severe feeding disorder, they can also induce side effects, such as diarrhea and somnolence, which limit their widespread use. Various types of herbal medicines have long been used to prevent and treat numerous gastrointestinal tract diseases; however, to date, no study has been conducted to analyze and summarize their effects on cisplatin-induced anorexia. In this paper, we analyze 12 animal studies that used either a single herbal medicine extract or mixtures thereof to decrease cisplatin-induced anorexia. Among the herbal medicines, Ginseng Radix was the most used, as it was included in seven studies, whereas both Glycyrrhizae Radix et Rhizoma and Angelicae Gigantis Radix were used in four studies. As for the mechanisms of action, the roles of serotonin and its receptors, cytokines, white blood cells, ghrelin, and leptin were investigated. Based on these results, we suggest that herbal medicines could be considered a useful treatment method for cisplatin-induced anorexia. Full article
(This article belongs to the Special Issue Clinical Development of Cancer Treatment)
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31 pages, 641 KiB  
Review
Therapeutic Use of Valproic Acid and All-Trans Retinoic Acid in Acute Myeloid Leukemia—Literature Review and Discussion of Possible Use in Relapse after Allogeneic Stem Cell Transplantation
by Øystein Bruserud, Galina Tsykunova, Maria Hernandez-Valladares, Hakon Reikvam and Tor Henrik Anderson Tvedt
Pharmaceuticals 2021, 14(5), 423; https://doi.org/10.3390/ph14050423 - 2 May 2021
Cited by 6 | Viewed by 3772
Abstract
Even though allogeneic stem cell transplantation is the most intensive treatment for acute myeloid leukemia (AML), chemo-resistant leukemia relapse is still one of the most common causes of death for these patients, as is transplant-related mortality, i.e., graft versus host disease, infections, and [...] Read more.
Even though allogeneic stem cell transplantation is the most intensive treatment for acute myeloid leukemia (AML), chemo-resistant leukemia relapse is still one of the most common causes of death for these patients, as is transplant-related mortality, i.e., graft versus host disease, infections, and organ damage. These relapse patients are not always candidates for additional intensive therapy or re-transplantation, and many of them have decreased quality of life and shortened expected survival. The efficiency of azacitidine for treatment of posttransplant AML relapse has been documented in several clinical trials. Valproic acid is an antiepileptic fatty acid that exerts antileukemic activity through histone deacetylase inhibition. The combination of valproic acid and all-trans retinoic acid (ATRA) is well tolerated even by unfit or elderly AML patients, and low-toxicity chemotherapy (e.g., azacitidine) can be added to this combination. The triple combination of azacitidine, valproic acid, and ATRA may therefore represent a low-intensity and low-toxicity alternative for these patients. In the present review, we review and discuss the general experience with valproic acid/ATRA in AML therapy and we discuss its possible use in low-intensity/toxicity treatment of post-allotransplant AML relapse. Our discussion is further illustrated by four case reports where combined treatments with sequential azacitidine/hydroxyurea, valproic acid, and ATRA were used. Full article
(This article belongs to the Special Issue Clinical Development of Cancer Treatment)
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16 pages, 1173 KiB  
Review
Co-Clinical Trials: An Innovative Drug Development Platform for Cholangiocarcinoma
by Brinda Balasubramanian, Simran Venkatraman, Kyaw Zwar Myint, Tavan Janvilisri, Kanokpan Wongprasert, Supeecha Kumkate, David O. Bates and Rutaiwan Tohtong
Pharmaceuticals 2021, 14(1), 51; https://doi.org/10.3390/ph14010051 - 11 Jan 2021
Cited by 6 | Viewed by 4848
Abstract
Cholangiocarcinoma (CCA), a group of malignancies that originate from the biliary tract, is associated with a high mortality rate and a concerning increase in worldwide incidence. In Thailand, where the incidence of CCA is the highest, the socioeconomic burden is severe. Yet, treatment [...] Read more.
Cholangiocarcinoma (CCA), a group of malignancies that originate from the biliary tract, is associated with a high mortality rate and a concerning increase in worldwide incidence. In Thailand, where the incidence of CCA is the highest, the socioeconomic burden is severe. Yet, treatment options are limited, with surgical resection being the only form of treatment with curative intent. The current standard-of-care remains adjuvant and palliative chemotherapy which is ineffective in most patients. The overall survival rate is dismal, even after surgical resection and the tumor heterogeneity further complicates treatment. Together, this makes CCA a significant burden in Southeast Asia. For effective management of CCA, treatment must be tailored to each patient, individually, for which an assortment of targeted therapies must be available. Despite the increasing numbers of clinical studies in CCA, targeted therapy drugs rarely get approved for clinical use. In this review, we discuss the shortcomings of the conventional clinical trial process and propose the implementation of a novel concept, co-clinical trials to expedite drug development for CCA patients. In co-clinical trials, the preclinical studies and clinical trials are conducted simultaneously, thus enabling real-time data integration to accurately stratify and customize treatment for patients, individually. Hence, co-clinical trials are expected to improve the outcomes of clinical trials and consequently, encourage the approval of targeted therapy drugs. The increased availability of targeted therapy drugs for treatment is expected to facilitate the application of precision medicine in CCA. Full article
(This article belongs to the Special Issue Clinical Development of Cancer Treatment)
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